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Journal of Clinical Microbiology, November 2007, p. 3568-3573, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00655-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Monitoring of Polyomavirus BK Virus Viruria and Viremia in Renal Allograft Recipients by Use of a Quantitative Real-Time PCR Assay: One-Year Prospective Study

Provincial Laboratory for Public Health (Microbiology), University of Alberta Hospital,¹ Division of Infectious Diseases,² Division of Nephrology and Immunology,³ Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada⁴

Received 23 March 2007/ Returned for modification 19 August 2007/ Accepted 3 September 2007

We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including those with BK virus-associated nephropathy (BKVAN) (n = 8), those undergoing routine posttransplant surveillance (SV) (n = 155), those with nontransplant chronic kidney disease (NT-CKD) (n = 20), and healthy living kidney donors (LD) (n = 20). The rt-QPCR assay was found to be highly sensitive and specific, with a wide dynamic range (2.4 to 11 log₁₀ copies/ml) and very good precision (coefficient of variation, 5.9%). There was a significant difference in the prevalences of viruria and viremia between the BKVAN (100% and 100%) and SV (23% and 3.9%) groups (P < 0.001). No viruria or viremia was detected in LD or in NT-CKD patients. The median (range) peak levels of BK virus viruria and viremia, in log₁₀ copies/ml, were 10.26 (9.04 to 10.83) and 4.83 (3.65 to 5.86) for the BKVAN group versus 0 (0 to 10.83) and 0 (0 to 5.65) for the SV group, respectively (P < 0.001). When the BK virus load in the urine was <7.0 log₁₀ copies/ml, no BK virus viremia was detected. When the BK virus load in the urine reached 7.0, 8.0, 9.0, and 10.0 log₁₀ copies/ml, the corresponding detection of BK virus viremia increased to 20, 33, 50, and 100%, respectively. We propose monitoring of BK virus viruria in RTRs, with plasma BK virus load testing reserved for those with viruria levels of 7.0 log₁₀ copies/ml.

Published ahead of print on 12 September 2007.

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• Costa, C., Bergallo, M., Astegiano, S., Terlizzi, M. E., Sidoti, F., Segoloni, G. P., Cavallo, R. (2008). Monitoring of BK virus replication in the first year following renal transplantation. Nephrol Dial Transplant 0: gfn289v1-gfn289 [Abstract] [Full Text]